Ruxolitinib resistance or intolerance in steroid-refractory acute graft-versus-host disease - a real-world outcomes analysis

Br J Haematol. 2021 Nov;195(3):429-432. doi: 10.1111/bjh.17700. Epub 2021 Jul 12.

Abstract

Ruxolitinib for steroid-refractory acute graft-versus-host disease (SR-aGVHD) results in resistance or intolerance in 1/5 of patients. Outcomes of such patients are undefined. We identified these patients in a multicentre review and reported outcomes. Ruxolitinib-resistant aGVHD was identified in 48/307 patients. Among patients receiving additional therapy, the overall response rate to next therapy was 36%. Median survival was 21 days. Ruxolitinib intolerance led to treatment discontinuation in 16/307 patients. Ten intolerant patients received additional therapy with 50% experiencing continued improvement of aGVHD. Median survival was 50 days in these patients. These data serve as a baseline for future SR-aGVHD studies.

Keywords: graft-versus-host disease; stem cell transplantation; transplant.

Publication types

  • Multicenter Study

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Allografts
  • Bone Marrow Transplantation / adverse effects
  • Cord Blood Stem Cell Transplantation / adverse effects
  • Drug Resistance
  • Female
  • Graft vs Host Disease / drug therapy*
  • Graft vs Host Disease / mortality
  • Graft vs Host Disease / prevention & control
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Middle Aged
  • Nitriles / adverse effects
  • Nitriles / pharmacology*
  • Nitriles / therapeutic use
  • Peripheral Blood Stem Cell Transplantation / adverse effects
  • Pyrazoles / adverse effects
  • Pyrazoles / pharmacology*
  • Pyrazoles / therapeutic use
  • Pyrimidines / adverse effects
  • Pyrimidines / pharmacology*
  • Pyrimidines / therapeutic use
  • Retrospective Studies
  • Salvage Therapy
  • Young Adult

Substances

  • Immunosuppressive Agents
  • Nitriles
  • Pyrazoles
  • Pyrimidines
  • ruxolitinib